HomeMy WebLinkAboutR 2014-441 Finance - A Helping Hand - Outside Agency Performance Agreement ao l-14--L+J+1
ORANGE COUNTY—CONTRACT CONTROL SHEET
Routing Order: (1)Department, (2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk
This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager
determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for
BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for legal review should
be completed through the legal review process prior to being routed for signature.
Department
Party/Vendor Name: A Helping Hand Party/Vendor Contact Person: Ryan Stancil Contact Phone: 919-403-5555 Party/Vendor
Address: 1502 W NC Hwy 54, Ste 405 City Durham State:NC Zip: 27707 Department: Finance&Admin. Services Amount: $2,000
Purpose: Performance Agreement Budget Code(s): 10495050-720085 Vendor#800034 (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑No® Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date 7/1/2014 Approved by
Board Yes®No❑ Agenda Date: 6/17/2014 Title of Contract: 2014-15 Outside Agency Performance Agreement
If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for bid were
bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature: �� � 1 Date: `Q
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IT Director
(Applicable only to hardware/software purchases or related services)This contract has been reviewed and approved by the Information
Technology Director as to technical content and information technology specifications:
IT Director's Signature: Date:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as sho
by the Risk Manager: D O
Risk Manager's Signature: Date: AUG 2014
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Financial Services
This Contract is conditionedJipon appropriation by the Board of Commissioners Yes❑ .No Abu
before approval Yes❑No If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the
manner required by the Local Government Budget and Fiscal Control Act:
Financial Services Director's Signature: '"w ""^ Date: �lql,
��Z43
County Attorney
Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approval Manager[(Most other contracts$1,000 and above). Department Director approval only ❑ (Under
$1,000). This contract has been re iewed and approved by the Attorney as to legal form and sufficienggcy:
Attorney's Signature Date: p
County Manager
This contract has been reviewed and is approved by the County Manager Yes .
This contract has been reviewed and is for signature by the Chair Yes❑No❑.
Manager's Signature: Date:
Clerk to the Board
Approved by BOCC on the day of S mitted for Chair signature on the_day of 20
Clerk's Signature: Date: !
Revised March 2012